Implementation science for global oncology: The imperative to evaluate the safety and efficacy of cancer care delivery

Neo M. Tapela*, Tharcisse Mpunga, Nadine Karema, Ignace Nzayisenga, Temidayo Fadelu, Frank R. Uwizeye, Lisa R. Hirschhorn, Marie Aimee Muhimpundu, Jean Paul Balinda, Cheryl Amoroso, Claire M. Wagner, Agnes Binagwaho, Lawrence N. Shulman

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations

Abstract

Purpose. The development of cancer care treatment facilities in resource-constrained settings represents a challenge for many reasons. Implementation science-the assessment of how services are set up and delivered; contextual factors that affect delivery, treatment safety, toxicity, and efficacy; and where adaptations are needed-is essential if we are to understand the performance of a treatment program, know where the gaps in care exist, and design interventions in care delivery models to improve outcomes for patients. Methods. The field of implementation science in relation to cancer care delivery is reviewed, and the experiences of the integrated implementation science program at the Butaro Cancer Center of Excellence in Rwanda are described as a practical application. Implementation science of HIV and tuberculosis care delivery in similar challenging settings offers some relevant lessons. Results. Integrating effective implementation science into cancer care in resource-constrained settings presents many challenges, which are discussed. However, with carefully designed programs, it is possible to perform this type of research, on regular and ongoing bases, and to use the results to develop interventions to improve quality of care and patient outcomes and provide evidence for effective replication and scale-up. Conclusion. Implementation science is both critical and feasible in evaluating, improving, and supporting effective expansion of cancer care in resource-limited settings. In ideal circumstances, it should be a prospective program, established early in the lifecycle of a new cancer treatment program and should be an integrated and continual process.

Original languageEnglish (US)
Pages (from-to)43-52
Number of pages10
JournalJournal of Clinical Oncology
Volume34
Issue number1
DOIs
StatePublished - Jan 1 2016

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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